UNIVERSITY ADVANCEMENT IN-KIND GIFT GENERAL USE ACCEPTANCE FORM
FOR INTERNAL USE ONLY – NOT TO BE SHARED WITH DONOR
Use this form for gifts that will be used or consumed at a special event or for simple in-kind gifts (items that do not
require installation, do not contain hazardous materials, etc.)
☐ Donor wishes to remain anonymous
Mr. ☐ Mrs. ☐ Ms. ☐ Dr. ☐ Donor Name: _______________________________________________________________
Mr. ☐ Mrs. ☐ Ms. ☐ Dr. ☐ Company Contact Name*: __________________________________________________
*Applicable if donor is an organization; please note if contact is owner
Street Address: _____________________________________________________________________________________________________
City: ________________________________________ State: ________ Zip: ___________ Business Phone: ___________________
E-mail: ________________________________________ Cell Phone: ___________________ Home Phone: ___________________
Website: __________________________________ Alumna/Alumnus ☐ Grad. Year: ______ Faculty/Staff ☐ Friend ☐
Department Responsible for Gift: ___________________________________________________________ Campus Zip: _______
Solicitor’s Name: _________________________________________________________________ Campus Extension: ____________
Date Gift Physically Received: _________________ Value of Gift: $________________ Valuation Date: _________________
Valuation Made by*: ________________________________________________________________________________________________
*must be off-campus affiliate
Valuation Based on*: _______________________________________________________________________________________________
*Attach documentation (e.g. appraisal, written quote, copy of catalog prices, etc.)
Gift Description: *Include the following details, if applicable: dimensions, material, age/year manufactured, make/model, etc.
Annual Fund Account Number to Credit: ___________ Special Event (if applicable): _______________________________
Department Chair/Unit Director: _______________________________________________________________ Date: ____________
Dean/Unit Administrator: ______________________________________________________________________ Date: ____________
Executive Director of Advancement Services: __________________________________________________ Date: ____________
*For In-Kind Gifts not associated with a Special Event, Development Officer signature is REQUIRED*
Development Officer: __________________________________________________________________________ Date: ____________
*If you do not have a development officer for your college/unit, please send to Evelyn Buchanan, Associate Vice President for University Advancement, for signature
Make a copy of this form for your records. Send original and ALL accompanying documentation to University Advancement (Zip 0155).
